Lab Test Form

Please complete one form per child.

Consent for Laboratory Testing: I understand that the cost of laboratory tests is not covered by insurance and may range between $350-$450 (+ Shipping), depending on the selected package. After submitting this form, I will receive an invoice for the laboratory tests. Upon completing payment of the invoice, the test kit will be mailed to me. After I send the completed test back to the lab, it may take 4-6 weeks to receive the results. These results can be utilized in a subsequent appointment with Dr. Netsy or with my local healthcare practitioner.

Lab Test Form

Join Our Free Trial